河北省保定市HIV-1感染者毒株基因亚型和耐药研究

目的:了解河北省保定地区2020年全部新诊断的HIV-1感染者中,HIV-1毒株基因型和耐药发生情况。方法:使用自建的方法扩增HIV-1 pol区全长基因并测序,系统进化分析鉴定HIV-1亚型,将基因序列上传至美国斯坦福大学的HIV耐药数据库,分析耐药突变位点发生情况。 结果:共收集新诊断HIV...     

HIV-1拉米夫定(3TC)耐药毒株的体外诱导培育和鉴定

目的 通过体外传代培养，将我国HIV-1药物敏感毒株诱导为拉米夫定耐药毒株。方法 在MT4细胞-中国HIV-1B’亚型CNHN24毒株培养系统中加入0．008μmol／L拉米夫定，逐渐增加药物浓度进行传代和培养，每隔3～5代测定半数抑制浓度（IC50），并用RT-PCR法扩增plo区基因，进行基因型耐药性分析。将表型和基因型耐药结果与敏感株进行比较。结果 培养6代后，IC50由野生毒株的0．018／μmol／L逐渐提高到0．15μmol／L；第7代时，IC50突然增加到大于2048／μmol／L；pol区的184位氨基酸由甲硫氨酸（M）突变为异亮氨酸（I）。去除药物继续培养5代，IC50仍维持〉2048／μmol／L，pol区184位氨基酸仍为异亮氨酸，没有发生回复突变。结论 在国内首次用中国HIV-1毒株诱导培育出可能稳定传代的3TC耐药株，可用于HIV-1耐药性的研究和HIV-1药物的药效学评价。该耐药株已申请国家专利．     

对奈韦拉平耐药的HIV-1毒株诱导研究

目的 探讨对NVP耐药的Ⅰ型艾滋病病毒(HIV-1)毒株的诱导方法,获得能够产生连续稳定传代的对NVP高度耐药的HIV-1毒株.方法 MT4细胞中先后加入终浓度为100TCID50的HIV-1实验室毒株89.6与终浓度为10倍IC50的NVP药物溶液,在药物浓度不变的条件下传代,培育HIV-1病毒.提取每代培养液上清病毒RNA,逆转录后使用巢式PCR扩增HIV-1 pol区基因,收集目标片段并进行测序分析.结果 诱导培养所得耐药株由第5代开始与野生株相比,出现NVP IC50变化,倍数约为3倍,培养11代后,变化倍数高达178倍.此外,发生Y181C和Y188Y位点突变.结论 本实验中在体外经诱导所得耐药株对NVP具有较高的耐药性,并可获得稳定传代.     

HIV-1 CRF01AE毒株整合酶抑制剂主要耐药突变的表型耐药性研究

目的分析整合酶(IN)区主要耐药突变对HIV-1 CRF01_AE毒株耐药的影响, 并比较与B亚型毒株的差异。方法根据美国斯坦福大学HIV耐药数据库选择7个IN区突变或联合突变(T66K、F121Y、Q148K、N155H、G118R、R263K、Q148K/N155H), 通过无缝克隆同源重组及点突变的方法引入到HIV-1 B亚型感染性克隆pNL4-3和CRF01_AE感染性克隆pGX002的IN区, 转染293T细胞包装病毒, 在MT2细胞上扩大培养并测定感染性滴度。检测4种整合酶链转移抑制剂(INSTIs), 拉替拉韦(RAL)、埃替拉韦(EVG)、多替拉韦(DTG)、比昔格韦(BIC)对14株突变病毒的半抑制浓度(IC50)及其与野生型病毒相比提高的倍数。结果成功构建携带7个IN区突变或联合突变的B亚型和CRF01_AE质粒, 包装获得14株重组病毒, 感染性滴度为104～106半数组织细胞感染剂量(TCID50)/ml, 在MT2细胞高效复制, 上清液中HIV-1 P24抗原浓度可达830～2 700 ng/ml。5...     

我国HIV-1感染者耐药突变的流行性研究

目的 掌握我国大规模用药前耐药突变在我国HIV-1感染者中流行情况的本底资料。方法 在第二次全国HIV流行病调查2002年样本中随机选取20％，对于蛋白酶(PR)基因区全长和逆转录酶(RT)20～230氨基酸位点进行PCR扩增、测序并使用HIVdb-Drug Resistance Algorithm软件进行分析，检测耐药相关突变。结果 分别得到164份PR基因区样本和138份RT基因区样本。PR基因区样本中发现1份(0．61％)样本存在蛋白酶抑制剂(PI)主要相关突变，163份(99．39％)样本存在P1次要耐药相关突变。RT基因区样本中发现8份(5．80％)具有核苷类逆转录酶抑制剂(NRTI)耐药相关突变，2份(1．45％)存在非核苷类逆转录酶抑制剂(NNRTI)耐药相关突变。结论 我国未用药HIV感染者中耐药相关突变尚处于低流行状态，应当在用药过程中定期监控以减少耐药突变的产生与传播。     

2019—2020年山西省艾滋病抗病毒治疗失败者HIV-1基因型耐药及其影响因素分析

目的:分析山西省艾滋病(acquired immunodeficiency syndrome, AIDS)抗病毒治疗失败者HIV-1耐药检测结果及影响因素。方法:收集2019—2020年HIV/AIDS患者抗病毒治疗满1年的治疗失败者血浆样品,进行耐药基因检测及基因亚型判定,并分析其影响因素。结果:扩增成功率84.18...     

乙型肝炎病毒复制期与病毒耐药基因突变相关性

目的:研究乙肝病毒不同复制期与乙型肝炎患者抗病毒用药后基因突变两者的相关性。方法:选取203例慢性乙型肝炎患者血清标本为对象。经巢式PCR扩增及磁珠分离,制备焦磷酸测序单链模板,将PCR扩增得到HBV病毒P区和BCP区产物经焦磷酸测序进行突变频率检测,并在PyroMark ID遗传分析系统上进行焦磷酸测序。结果:检测乙型肝炎病毒DNA含量,按照HBV定量结果阳性(拷贝数≥103copies/ml)和阴性(拷贝数<103copies/ml)的标本分组分析,HBV定量阳性标本具有极高的敏感性。批量突变检测,乙型肝炎病毒复制率越高,突变率越高,检测率越高。结论:选择乙肝病毒的复制阳性标本,结合焦磷酸测序进行高通量、快速、准确检测耐药基因区突变,能满足临床批量用药检测及治疗方案设计的需要。     

基线极高HIV-1 RNA水平对初治HIV-1感染者外周血total HIV-1 DNA的影响

目的:观察基线HIV-1 RNA > 50万copies/mL的HIV-1感染者,在高效抗反转录病毒治疗（highly active antiretroviral therapy,HAART）前后外周血totalHIV-1 DNA的变化。方法:从国家十二五科技重大专项课题中选取基线HIV-1 RNA > 50万copi...     

DC-SIGN在树突状细胞传播HIV-1中作用的实验研究

目的探讨DC—SIGN在树突状细胞（DC）传播HIV-1中的作用。方法用M嗜性或T嗜性HIV-1原代分离株分别刺激未成熟DC（immature DC，iDC））和成熟DC（mature DC，mDC），数量与DC相同的CD4^T细胞作为对照组，与活化的CD4^＋T细胞共培养，用ELISA方法定量检测第4、7、10、14天共培养上清中p24抗原，观察Dc在传播HIV-1的作用。预先加入抗DC—SIGNMcAb和，或抗ICAM-3McAb，观察抗DC-SIGNMcAb和抗ICAM-3McAb对DC传播HIV-1作用的影响。结果用M嗜性HIV-1刺激的iDC以及用M和T嗜性HIV-1刺激的mDC的共培养上清中p24含量均随培养时间延长逐渐增加，显著高于对照组（P=0．001）。加入抗DC．SIGNMcAb后，共培养上清p24抗原明显降低；加入抗ICAM-3McAb后上清中p24抗原并不减少。用T嗜性HIV-1刺激的iDC共培养上清中p24含量不随培养时间延长逐渐增加，与对照组相比差异无统计学意义。结论iDC具有传播M嗜性HIV-1的作用，但不具有传播T嗜性HIV-1的作用；mDC既能将M嗜性也能将T嗜性HIV-1传播给CD4^T细胞。抗DC-SIGN McAb能够抑制DC传播HIV-1的作用，提示DC-SIGN在DC向T细胞播散HIV-1过程中可能发挥重要作用。     

HIV-1 RNA被有效抑制下T细胞与外周血中HIV-1前病毒DNA

目的:考察HIV-1 RNA被有效抑制下T细胞与外周血中HIV-1前病毒DNA的相关性。方法:对云南地区90例确诊为AIDS,HAART持续治疗时间超过6个月,血浆HIV RNA<50 Copies/ml的患者进行研究,采用Spearmans秩和相关回顾性分析CD4+、CD3+、CD8+、CD4+CD28+、CD4+CD45RA+、CD4+CD45RO+、CD38+、CD8+CD38+T细胞的绝对计数和相对计数与外周血中HIV-1前病毒DNA的相关性,同时考察HIV-1前病毒DNA拷贝数与HAART持续治疗时间的相关性。将90例患者根据HAART后CD4+T细胞绝对计数分为A(CD4+<200 cells/μl)、B(200≤CD4+≤349 cells/μl)、C(CD4+≥350 cells/μl)3组,考察3组间T细胞亚群的差别。结果:HIV-1前病毒DNA的log拷贝数与CD4+CD45RA+T细胞绝对计数呈负相关(r=-0.231,P<0.05),与CD4+CD45RA+T细胞相对计数呈明显负相关(r=-0.270,P<0.01);与CD38+T细胞绝对计数呈正相关(r=0.250,P<0.05);与HAART持续治疗时间无相关性。B、C组的CD3+T细胞绝对计数明显高于A组(P<0.01);C组的CD8+T细胞绝对计数高于B组的(P<0.05);B、C组的CD4+CD28+T细胞绝对计数和相对计数明显高于A组(P<0.01),C组的CD4+CD28+T细胞绝对计数高于B组(P<0.05);B、C组的CD4+CD45RA+T细胞、CD4+CD45RO+T细胞绝对计数明显高于A组(P<0.01),C组的CD4+CD45RA+T细胞、CD4+CD45RO+T细胞绝对计数高于B组(P<0.05),B、C组的CD4+CD45RO+T细胞相对计数高于A组(P<0.05);B、C组的CD8+CD38+T细胞绝对计数低于A组(P<0.05),B组的CD8+CD38+T细胞相对计数低于A组(P<0.05);C组的CD38+T细胞绝对计数高于A组(P<0.05)。A、B、C组的HIV-1前病毒DNA的log拷贝数分别为3.561±0.297 9,3.605±0.277 6,3.434±0.289 1(copies/ml),3组间无显著性差异(P>0.05)。结论:经过HAART治疗后HIV-1前病毒DNA可能处于稳定状态,HIV-1前病毒DNA拷贝数只是某些T细胞亚群数量改变的原因之一。     

Prevalence of drug resistant HIV-1 forms in patients without any history of antiretroviral therapy in the Republic of Guinea

To study the structure of human immunodeficiency virus (HIV)-1 drug resistance (DR) in patients with newly diagnosed infection. Residents of the Republic of Guinea (N = 2168) were tested for HIV using enzyme-linked immunosorbent assay (ELISA). Individuals with a positive result were further examined for the presence of viral load in blood plasma. HIV was analyzed using Sanger sequencing. The obtained sequences were genotyped using REGA (version 3.0) and analyzed in MEGA 7. Analysis for the presence of DR mutations was performed using the Stanford University HIV DR Database. Serological markers of HIV were detected in 239 people, which represents 11.02% of the entire sample. HIV RNA was detected in 58 people. The following subtypes were seen: HIV CRF02_AG (41.9%); A1 (29.1%); A3 (12.9%); URF A1_G (12.9%); and G (3.2%). In 25% of patients, at least one significant mutation was encountered leading directly to HIV DR. The mutations encountered cause resistance to NRTI and NNRTI; one case of multiple resistance was identified. Major resistance to protease inhibitor was not seen. The detection of HIV-1 mutations associated with DR, in individuals who have never received antiretroviral therapy, is a cause for concern. It suggests that: new infections are occurring with strains that already have resistance; and the expansion of resistance is not always directly associated with selective drug pressure. Among the likely reasons for the high prevalence of primary HIV DR in the Republic of Guinea, drug availability is probably the key. The consequence of this is the lack of adherence of patients to treatment, the formation and transmission of resistant variants of the virus in the population. These findings suggest the need to test patients for resistant virus variants before initiating treatment.     

北京市2006年新确认HIV-1感染者耐药突变的流行性研究

目的 研究北京市2006年新确认HIV-1感染者毒株的耐药突变本底数据.方法 随机选取北京市2006年新确认HIV-1感染者抗凝全血标本50份,提取血浆病毒RNA,用逆转录聚合酶链反应扩增HIV-1 pol区基因片段,并进行序列测定及耐药基因型分析.结果 成功扩增出34份标本的pol区基因;在1例样本的蛋白酶编码区检测出1个主要耐药突变,7例样本检测出7个次要耐药突变,主要耐药突变为M46L,毒株是CRF01_AE亚型,次要耐药突变有4种,出现的频率分别为A71T(2个)、A71V(3个)、Q58E(1个)、V11IV(1个).在14例样本逆转录酶编码区检测出一种或多种核苷类和(或)非核苷类逆转录酶抑制剂耐药突变,9例标本检出核苷类逆转录酶抑制剂耐药突变,出现频率分别为:V118I(42.9%)、M184V(7.1%)、A62V(7.1%)、K70T(7.1%)、K65R(7.1%)、K219N(7.1%)、T69d(7.1%)、V75LV(7.1%)、K219R(7.1%);10例标本检出核苷类逆转录酶抑制剂耐药突变,出现的频率分别为V1061(35.5%)、Y181C(15.4%)、K103KR(7.7%)、K103R(7.7%)、L100LV(7.7%)、V1081(7.7%)、V179D(7.7%)、V179DV(7.7%).结论 北京市2006年新确认HIV-1感染者毒株中已经存在一定比例耐药突变,有必要定期进行耐药性监测研究.     

中国HIV-1病毒分离株的生物学特性与疾病进展关系的研究

目的　从HIV AIDS患者应用微量全血法分离中国HIV 1毒株 ,研究HIV 1的生物学特性与HIV AIDS疾病进展相关性。方法　建立微量全血法 ,从HIV AIDS全血标本中分离 17株HIV 1病毒分离株 ;检测这 17株病毒分离株嗜性和复制动力。结果　从 2 6例HIV AIDS病例中分离出HIV 1病毒 ,分离率为 6 5 .4 % (17 2 6 ) ,其中 17例HIV 1感染者的病毒分离率为 5 2 .9% (9 17) ,均为巨噬细胞嗜性 (M嗜性 ,NSI) ;9例AIDS患者的HIV 1病毒分离率为 88.9% (8 9) ,其中 7株为T细胞嗜性 (T嗜性 ,SI) ,1株为巨噬细胞嗜性。通过检测P2 4抗原确定 17株HIV 1病毒分离株的复制动力。在分离到的 17株HIV 1中 ,SI型病毒分离株与AIDS组显著相关 (P <0 .0 5 ) ;AIDS期的病毒分离株的复制动力明显高于HIV感染期 (P <0 .0 5 )。结论　微量全血法可用于病毒分离。 17株分离株的HIV 1复制动力与CD4 + T淋巴细胞计数呈线性负相关 ,与病毒载量呈正相关。     

Evolution and recombination of genes encoding HIV-1 drug resistance and tropism during antiretroviral therapy

Characterization of residual plasma virus during antiretroviral therapy (ART) is a high priority to improve understanding of HIV-1 pathogenesis and therapy. To understand the evolution of HIV-1 pol and env genes in viremic patients under selective pressure of ART, we performed longitudinal analyses of plasma-derived pol and env sequences from single HIV-1 genomes. We tested the hypotheses that drug resistance in pol was unrelated to changes in coreceptor usage (tropism), and that recombination played a role in evolution of viral strains. Recombinants were identified by using Bayesian and other computational methods. High-level genotypic resistance was seen in ∼ 70% of X4 and R5 strains during ART. There was no significant association between resistance and tropism. Each patient displayed at least one recombinant encompassing env and representing a change in predicted tropism. These data suggest that, in addition to mutation, recombination can play a significant role in shaping HIV-1 evolution.     

广州市吸毒强戒人员HIV-1基因亚型分布的初步研究

目的分析吸毒人群HIV感染者中HIV-1的基因序列特征,初步确定其感染的基因亚型和各亚型的流行趋势。方法在Genbank中查找HIVgag基因的序列,设计巢式PCR引物。从全血中提取样本的基因组DNA,进行巢式PCR,对PCR产物进行琼脂糖凝胶电泳和测序,所获序列与国际参考株序列进行比对,确定基因型或亚型。结果对36例HIV-1感染者样本进行扩增,PCR共检测出29例阳性样本,27例测序成功,其中16例为CRF08-BC重组亚型、7例为CRF07-BC重组亚型、4例为CRF01-AE重组亚型,15例阴性对照均无目的条带。结论在广州吸毒强戒人员HIV-1型中以CRFBC亚型为主,其次为CRF01-AE亚型。应加强对HIV-1毒株亚型的监测,以制定更好的防治策略。     

HIV-1流行毒株HIV DNA的研究

目的 了解HIV－1流行毒株中HIV DNA的变异特性。方法 用逆转录PCR（RT－PCR）,长片段PCR（Long-Distance PCR LD-PCR)、分子克隆、杂交和测序等对63例HIV－1感染者外周血单个核细胞（PBMC）HIV DNA进行研究。结果 57例标本可明确定型,其中B亚型43例,C亚型5例,E亚型9例。57例中31例既存在完整又存在不完整的HIV－1 DNA,19例只存在不完整的HIV－1 DNA片段,7例只有完整的HIV－1 DNA,缺失的最大范围为7759个碱基,最小范围71个碱基,以多片段缺损最为常见。结论 HIV DNA基因片段变异在HIV感染和流行传播中是非常重要的。     

Point mutations in the C-terminus of HIV-1 gp160 reduce apoptosis and calmodulin binding without affecting viral replication

One hallmark of AIDS progression is a decline in CD4+ T lymphocytes, though the mechanism is poorly defined. There is ample evidence that increased apoptosis is responsible for some, if not all, of the decline. Prior studies have shown that binding of cellular calmodulin to the envelope glycoprotein (Env) of HIV-1 increases sensitivity to fas-mediated apoptosis and that calmodulin antagonists can block this effect. We show that individual mutation of five residues in the C-terminal calmodulin-binding domain of Env is sufficient to significantly reduce fas-mediated apoptosis in transfected cells. The A835W mutation in the cytoplasmic domain of gp41 eliminated co-immunoprecipitation of Env with calmodulin in studies with stably transfected cells. Four point mutations (A835W, A838W, A838I, and I842R) and the corresponding region of HIV-1 HXB2 were cloned into the HIV-1 proviral vector pNL4-3 with no significant effect on viral production or envelope expression, although co-immunoprecipitation of calmodulin and Env was decreased in three of these mutant viruses. Only wild-type envelope-containing virus induced significantly elevated levels of spontaneous apoptosis by day 5 post-infection. Fas-mediated apoptosis levels positively correlated with the degree of calmodulin co-immunoprecipitation, with the lowest apoptosis levels occurring in cells infected with the A835W envelope mutation. While spontaneous apoptosis appears to be at least partially calmodulin-independent, the effects of HIV-1 Env on fas-mediated apoptosis are directly related to calmodulin binding.     

Cross-clade neutralization patterns among HIV-1 strains from the six major clades of the pandemic evaluated and compared in two different models

A panel of paired primary virus isolates and envelope pseudoviruses from sixty strains representing six HIV-1 clades was tested for neutralization using pooled, clade-specific plasma in two prominently utilized neutralization platforms: a primary isolate assay using peripheral blood mononuclear cells (PBMC) and a pseudovirus assay using a reporter epithelial cell line. Using the PMBC assay, pairing of the antibody pool against homologous clade viruses generated the highest geometric mean neutralizing antibody titer in 4 out of 6 clades tested, and neutralization patterns showed numerous examples of reciprocal cross-recognition between antibody and viruses of specific clade pairs. In the pseudovirus assay, cross-clade neutralization was more limited, with fewer distinct cross-clade relationships evident. The clade C antibody pool was broadly cross-reactive, neutralizing the greatest number of viruses in both assays. These data highlight the importance of the neutralization assay format employed and suggest that clade C envelopes merit further evaluation for the elicitation of broadly neutralizing antibodies.